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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 5/12/2017 <br />Submitted on: 5/11/2017 4:41:03PM <br />Submitted by: Heather Fraser Email: heather@sanbornchevrolet.com <br />CERS ID: 10187089 <br />Facility ID in CERS: FA0019193 <br />Facility name SANBORN CHEVROLET PROLUBE SHOP SANBORN CHEVROLET PROLUBE <br />Information prior to CIW processing <br />Information after CIW processing <br />CERS <br />OWNER INFORMATION <br />(current EC database) <br />(current submittal) <br />field <br />Facility phone 209-334-5000 (209) 334-5000 <br />Number of Facilities for this Owner <br />Facility mailing address PO BOX 1057 P.O. Box 1057 <br />108a <br />Owner ID <br />OW0004451 <br />BILLING INFORMATION <br />Owner name <br />Richard E. Sanborn <br />Richard E Sanborn <br />111 <br />Mailing address <br />P.O. Box 1057 <br />P.O. Box 1057 <br />113 <br />Contact email jcurl@tiehm.com heather@sanbornchevrolet.com <br />Lodi, CA 95241-1057 <br />Lodi, CA 95241 <br />114, 115, 116 <br />Work phone <br />209-334-5000 <br />(209) 334-5000 <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID FA0019193 <br />Facility name SANBORN CHEVROLET PROLUBE SHOP SANBORN CHEVROLET PROLUBE <br />SHOP 3 <br />Site address 1190 S CHEROKEE LN 1190 S CHEROKEE LN <br />103 <br />City LODI LODI <br />104 <br />ZIP code 95240 95240 <br />105 <br />Facility phone 209-334-5000 (209) 334-5000 <br />102 <br />Facility mailing address PO BOX 1057 P.O. Box 1057 <br />108a <br />LODI, CA 95241 Lodi, CA 95241 <br />108b, 108c, 108d <br />BILLING INFORMATION <br />Contact name SANBORN CHEVROLET PROLUBE SHOP Heather E. Fraser <br />140 <br />Address PO BOX 1057 P.O. Box 1057 <br />143 <br />LODI, CA 95241 Lodi, CA 95241 <br />144, 145, 146 <br />Contact phone 209-334-5000 (209) 334-5000 <br />141 <br />Contact email jcurl@tiehm.com heather@sanbornchevrolet.com <br />142 <br />Mail invoices to Account <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: <br />Assigned to: <br />Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ <br />] exempt from billing <br />le <br />Processed through CERS Integration Wizard by: '1"" � � Date: <br />Accounting: Reviewed by: t4115 Date: 5-I17 1 Clerical: [ ] File [ ] Relabel <br />file [ ] Create new file <br />�—] Arrt billeri r 1 SiirchamaQ i�� Ar�f By: <br />Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Record ID Employee name Status <br />Reactivated Inactivated <br />1921 - HMBP-Regular-Primary Location 8 chem units PR0539240 JAMIE LIMA Active <br />[ ] [ ] <br />2228 - GEN 25<50 TONS PERMIT PR0528517 ONE VACANT1 Inactive <br />[ ] [ ] <br />2332 - EXEMPT TANK FACILITY PR0528518 AARON HANG Inactive <br />2831 - AST FAC >/= 1,320 - <10 K GAL CUMULATIVE PR0537852 ONE VACANT1 Inactive <br />[ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0532142 not assigned Inactive <br />[ ] [ ] <br />